"About 55 percent of all physicians in the state are age 50 and over. But in rural areas it's much higher - 62 percent," says Kuhn. "So what this means is that we're going to have physicians in the rural areas in the state retiring earlier than in the urban areas. And, since we have so many fewer physicians in the rural areas, it does raise some issues in terms of access to care in the future."

Myra Evans heads a critical access hospital in Fairfax, Missouri, about 100 miles north of Kansas City. She's on MHA's board, but says the new report really resonates with the situation in her region.

"Three years ago a physician that was 57 left to be closer to his grandchildren, and then we had two physicians that were over 80 years old still practicing that retired," says Evans. "So, we actually are down to three physicians, and we're trying recruit at least two to our area. That's been kind of difficult right now."

Evans says her hospital is the only one serving about 11,000 people in the two-county area. She says one way they've dealt with the shortage of doctors is by bringing in more nurse practitioners.

The new MHA report, which reviewed existing workforce studies and population and health data, anticipates rural health challenges to be an even bigger problem come 2014: that's when another half million Missourians are expected to gain health coverage through provisions under the federal health law.

The report recommends the state look into new ways to avert the crisis - that could include better use of information technology, revamping loan-assistance programs for health professionals, and improving science education in rural secondary schools.